By Grant D. Bosse Summary: Certificate of Need laws, or CONs, have been set up across the country under the assumption that rationing hospital construction and expansion would limit increases in health care costs. Four decades of experience have shown that CONs do not control costs, but do provide a significant barrier to entry to [...]

Charlie Arlinghaus February 1, 2012 As originally published in the New Hampshire Union Leader MOST PROPOSALS on health care are part of a highly charged ideological debate. One exception this year, the health care compact, is not a short-term solution but a longer-term project that will allow New Hampshire to benefit by letting other states [...]

The current legislature and governor are pushing us to establish a new government agency to control hospitals by setting prices and overseeing hospital management. Similar bureaucracies have been abandoned in more than thirty states that tried them. That model cannot be replicated here without spending more than $100 million that we don’t have.

If Washington’s health care fiasco isn’t bad enough, Sen. Maggie Hassan wants to create a new state agency to set and control hospital prices and manage health care. The new Health Services Cost Review Commission is based on the belief that the secret to better, more cost efficient management is to create a new government agency….

We spend a lot of money as a society on perhaps the best health care system in the world. A less desirable way to reduce those costs is to ration care by one system or another. A better solution will focus on a growth strategy to improve health and eliminate complications by managing the chronic conditions and health risks that drive almost all the system costs.

Too much of the discussion of the increase in health care costs implicitly views consumers as unchanging commodities and tries to shift costs for a fixed set of events from one set of payers to another. But just as tax policy must consider the dynamic effects of economic growth and changing incentives, health policy too must have a dynamic, pro-growth (or pro-health) component.

Over the last year, states from coast to coast have considered the policy implications of importing prescription drugs from Internet pharmacies in Canada. Proposals have faced opposition from state pharmacists, every major Canadian pharmacist organization, and a concise condemnation from the Canadian Medical Association: “We feel Internet pharmacies could jeopardize patient safety and we’re against them.”

The goal is to determine what is known and not known about the health status of citizens and availability of health care providers in the North Country, and then set priorities for filling the data gaps. Where it was possible to provide new data on the North Country related to health care, such data are provided. Policy Needs Drive Data Needs Public policy needs drive the need for data. There appear to be two primary data needs. First, it is important to target resources to where they are most needed. For this reason it is important to have comparable data on various parts of the state.